HomeMy WebLinkAbout0172 OCEAN VIEW AVENUE - Health GeAyI V ieUJ PWftkKL.t CAT.0►T
033-01C '
S M E A D
No. 153L
UPC 10330
HASTINGS,MN
o
@,"61's
'i
r
A
0
I
c
F
1
Town of Barnstable ,
' Department of Regulatory Services ,.
Public Health Division Date
A tdyg. 200 Main Street,Hyannis MA 02601
PF�r 43 b 31)
Date Scheduled 0 / Time Fee pd. by, ro ��.
c
Soil Suitability .A,.ssessment,fog° Sewa
Performed By: Witnessed By:
LOCATION& GENERAL INFORM/ ION `
Location Address I'M oc-ec� ' Owner
�i[✓.i�. 's Name ����, �
cofV �J Address f�Z �C•e?✓� v � /�
Assessor's Map/Parcel: Engineer's Name �S t ,
NEW CONSTRUCTION REPAIR �
Telephone ft Z_�lpv--��l�
Land Use _ w" Slopes m ` Surface Stones . Nr7 v VtQ
Distances from: Open Water Body 1 ft Possible Wet Area 7 ft Drinking Wa[er�Geft'_� ft
p� �Drainage Way 70' led. ft Property Line ft Other ft
SIKETCH.,(Street name,dimensions of lot,exact locations Of
test holes&pare tests,locate wetlands fn mxirnit to holes
P Y )
CAL
��.
(
Parent material(geologic) L V "fn Depth to Bedrock
Depth to Groundwater. Standing Water in Hole:- � r Weeping from Pit Pace No
Estimated Seasonal High Groundwater > w be low Irade—
DETEIIl!'IINAT'ION FOR SEASONAL HIGH WATER TABLE
Method Used: //
Depth bserved standing in obs.hole: A/0 In, Depol to Sol]Inottler !fZLQ ljt,
Depth to weeping from side of obs.hole: in, Groundwater Adjustment ft.
Index Well Ir - Reading Date: -- Lndek Well leveI --
PE RCOLATI.ON TEST ]Dute
Observation
Hole# Tinto At h"
�D
Depth of Pere � Time at 6"
Start Pre-soak Time @ Z/ Time(9"-6") .
End Pre-soak n� ' �b
Rate Min./Inch /H �4
Site Suitability Assessment: Site Passed V/ Site Failed: Additional Testing Needed(Y/N)
Original: Public Health Division Observation Hole Data To Be Completed on Back-----------
***If percolation test is to be conducted within 1001 of wetland,you must first notify the.
Barnstable Conservation Division at least one(1) week prior to beginning. ri
Q:1S EPTICIPE R CFO RM.DOC
DEEP-OBSERVATION HOLE LOG Hole# /
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Stnucture,Stones;Boulders.
onsistency,%t3ravel)
0°- 1 A' 10AM, 16 yR 3'/z Nb tP.
• 1 - 3 8 � �,td is o ��� `��-�(
3b� 3z G Awl SGad 2•S . Gl2lwt �l
DEEP OBSERVATION HOLE LOG Vole# 2
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders,
(onsisten % ra
16 yp
-!3 z '! G�Pw
DEEP OBSERVATION MOLE LOG Hole# 3
Depth from Soil Horizon Soil Texture Soil Color Soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency.%O e
- S A toy?, IA
DEEP OBSERVATION HOLE LOG Hole#
Depth from Soil Horizon Soil Texture Soil Color soil Other
Surface(in.) (USDA) (Munsell) Mottling (Structure,Stones,Boulders.
Consistency,
�� -3a ►� i*o sl
.3 8 -02- cl- yam. sand- 2.5 V
I+lood Insurance Rate Map:
_ Above 500 year flood boundary No Yes
Within 500 year boundary No V Yes _
Within 100 year flood boundary No.V Yes
Depth of Naturally Occurring Pervious Material
Does at least four feet of naturally occurring pervious material exist in all areas observed throughout the
area proposed for the soil absorption system?
If not,what is the depth of naturally occurring p rvious material's
Certification
I certify that on Apo (date)I have passed the soil evaluator examination approved by the
Department of Environmental Protection and that the above analysis was performed by me consistent with
the required tritining,expertise and experience described in 10 CMR 15.017.
Signatur Date
Q:\UPT1C\PERCFORM.DOC
TOWN OF BARNSTABLE
LU'-A IOtV E?� ��c�.9 .. .mow �v SEWAG% ?. '7
VILLAGE �6 y ! ASSESSOR'S MAP & LOT 03 3- D
INSTALLER'S NAME & PHONE NO./%1CA ll�f? � ) 3
SEPTIC TANK CAPACITY AndO 6 ie1
LEACHING FACILITY:(type)/ GCG'S%��T (size)
J �
NO. OF BEDROOMS , PRIVATE WELL OR PUBLIC WATER/y//c--
i
BUILDER OR OWNER
DATE PERMIT ISSUED:
DATE COMPLIANCE ISSUED: 1-
VARIANCE GRANTED: Yes Noli'�
i
1
1 �
Iva � 3
aZ �
PooX
I G Rr21�.r
� 33
THE COMMONWEALTH OF MASSACHUSETTS
BOAR® .OF HEALTH arm rvOVED
TOWN OF BARNSTABLE atrong�
,� ltrttiaan fnri� A �g1 ,axk C� 'g�rr i ��....,,
Application is hereby made for a Permit to Construct ( ) or Repair A an Individual Sewage Disposal
System at:
--_-_----------------•----•-•------------------------••------------------------------- --------•---------------� -_ ---•-------------•--------___------------------------------------
/ Location-Address or Lot No.
00`rvsv c /� 5A 2
---------------------------...---•-----......------....------------•--••---••-------•-----.._..._ ._.....-----••----------------.._....-----..._._....-----------------•---•--............-----...--
Owner Address
a �GLcf/ �oi�5? . .... -v.viS
Installer Address
d Type of Building Size Lot............................Sq. feet
U Dwelling—No. of Bedrooms________________________________ _____Expansion Attic ( ) Garbage Grinder ( )
114 Other—T e of Building No. of persons____________________________ Showers — Cafeteria
P4 . Other fixtures ......................................................
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
WSeptic Tank—Liquid capacity............gallons Length................ Width---------------- Diameter__-_____________ Depth................
Disposal Trench—No_ ____________________ Width.................... Total Length.........._......... Total leaching area....................sq. ft.
Seepage Pit No..................... Diameter.................... Depth below inlet.................... Total leaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
Percolation Test Results Performed by.......................................................................... Date........................................
a Test Pit No. 1________________minutes P per inch Depth of Test Pit______._._.__.__.___ Depth to oun e>i n
P qe
Test Pit No. 2................minutes per inch Depth of.Test Pit---:---------------- Depth to group; r__ ..................
•-------•----------------------- --••---••---------•-------._.......------------------------••------------------------ ..........................
ODescription of Soil...............................................................................--------------------------------•--•------------- rr
V
W --------••------------------•- •-----•••-•-••------••-----------------------------------------•--------------------------•------------
UNature of Repairs or Alterations—Answer when applicable____ G DPE_____......................� #_____________________
Agreement:
The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in a 'dance with
the provisions of TITLE 5 of the State Environmental Code—The undersigned further agrees q ace the
system in operation until a Certificate of Compli has be issued by th r of he h.
Signed ---- ..................... ............................................ ell
-------
Application Approved By ...................... .- ........ ... �. ...- "�/
Dare
Application Disapproved for the following reasons- -------------------------------------------------------- --------------- -- -------...-..--...---------....------------
...........................................................,.......---------...--...--....--------- --....----....--- ----.-..---....--- --- ----..---...--....--- ------............................ .......................................
Permit No. -------.. ."- -5-�-�..................... Issued ------- ---- ---------------------------------------Date
Dare
No...
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
App iration for Dbgasa1 Works C ivilum scion rhwt
Application is hereby made for a Permit to Construct ( ) or Repair ()<) an Individual Sewage Disposal
System at:
/ Location-Addre or Lot No.
iL G ��
........... - O ss ..............................-.......--- ------------------•-•----••----...........----
1 Owner Address
a �L c�! rp sa. 5 I- %�'v.v/ 5-
------•.............................•---...--.•.... ----•---.....-•----•-•--•--.........-•-•-•--------.................-•-••-..
r
Installer Address
Q Type of Building - Size Lot............................Sq. feet
Dwelling=No. of Bedrooms.............. ...........................Expansion Attic ( ) Garbage Grinder ( )
aOther—Type of Building ............................ No. of persons..........--................ Showers ( ) — Cafeteria ( )
d Of-ier fixtures ------------------------------------------------
W Design Flow............................................gallons per person per day. Total daily flow............................................gallons.
1:4 Septic Tank—Liquid capacity............gallons Length------......... Width................ Diameter--........--..-- Depth................
Disposal Trench—No..................... Width.................... Total Length.................... Total leaching area....................sq. ft.
Seepage Pit No----------------- Diameter..'----------....... Depth below inlet.................... Totatleaching area..................sq. ft.
Z Other Distribution box ( ) Dosing tank ( )
'_q Percolation Test Results Performed by.......................................................................... Date.........................................
Test Pit Ne. I................minutes per inch 'Depth of Test Pit....----........--.. Depth to ground water..--....................
1-4
rX4 Test Pit No. 2................minutes per inch Depth of Test Pit.................... Depth to ground water........................
.............................................................................................................•----•--••----••-------•--•-••---•--------.----
x J Description o f,Soil----•-----•--•-•••••--------------•--•-•----•-----•---•--•-........-••--•---••--•------------•--------------•......----••--------.....................................
U ........................................•....................................................................................................... .........................................................
W
U Nature of Repairs or Alterations—Answer when applicable-----U. r/r
.......... .....................-��-Q•v--S %
L /� ao v ....................-.............................................
Agreement: r�i t_1
(The undersigned agrees to install the aforedescribed Individual Sewage Disposal System in accordance with
the provisions-of TITLE(5 of the State Environmental Code—The undersigned further agrees not.to place the
system in operation until a Certificate of Compliane has been-issued by the board,of hegph. ;
Signed �/- '. .. ............... 6}----------
ApplicationApproved By ---------- ---J - �..................... ------------------------------------------ ------�
Date
Application Disapproved for the following reasons- ......................................... ------- ------ ----------- ------ --------------------------_....--....................
.................................... .............G----------
---..................-- -----------.......... ..... ................... ......................... ....... r
Permit No. ----:...... /---------5 l..�---------------------- Issued ........-----..........E. - Da e
Dale
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
C rrttftrate of Contylian e
THIS IS TO CERTIFY That the Individual Sewage Disposal System constructed rN
���// Cd•�s T g p Y ( ) or l��e aired
by.........................................�------ .,
............................................I...........-Ins[aller........-...----..-.----------.-..... -.....-.............---........--.�......-_;_:....:.............................
at ................. .. .........................................................U� w
�G 7-
----------------------------------- ......------... . --- ---------- ....--------------=----.......---------------------------
has been installed in accordance with the provisions of TITLE 5 AThe State Environmental.: de as described in
the application for Disposal Works Construction Permit No. .........-Y--------9....... dated i";;r......................................
THE ISSUANCE OF THIS CERTIFICATE SHALL NOT BE CONSTRUED AS A GUAR WTEE THAT THE
SYSTEM WILL FUNCTION SATISFACTORY.
Inspector ..... N
DATE -a-....---.....7....
THE COMMONWEALTH OF MASSACHUSETTS
BOARD OF HEALTH
TOWN OF BARNSTABLE
No.... .....
- FEE. .(..............
Dish sal lVorks Tom wn Vrrmft
Permission is hereby granted..................../.,9 2.
-•----------------------
to Construct ( or Repair (--"/) an Individual Sewage Disposal-System
at No...............Z 2:f .......... C ....................................................cv '0 Ut �p 7 C�" T
----------- .........................................................................
Street
as shown on the application for Disposal Works Construction Permit No. -1:1. ....... Dated..........................................
--------------------------------- .......................................................
DATE. :� ( _ Board of Health
FORM 36508 HOBBS&WARREN,INC.,PUBLISHERS
3/10/2005 6 12 PM
m __________________________________________
m m �
r
N A5G 1-3351 N Z
? 31 3/4%4A 3/4
:r• u ASGDH-33/4 Z
• u o -________
o r DH-3,s, rn r -{
m
_ 1
1 i
i i N 1
4.016 CD.
LL
V 4._I. 2"'• r V =
A � Z
Z A M-2141 FT
IA 3/4 X 3-5 3/4 -'
ASLLM-2141 EFT y Q
I9 3/4 X 35 54zTs L z
ffPP
A M-14 a'� rn Z '
Iq 3/4 X}5 3/4
rn
CN
2'-3'
i
c
_ ii i• r 9 !____________________
---------------------
A FI 161-R ON. yy p p r u1
3-It/4% - /2 Z
A500H-295, m 1 D D � � I Qy
2-5 3/4 X d-q /
IF
H
e 1H,
j _ d ..:
d 7-31/2' Op -�_I _ 1i3/h•
V Ell
e.-2. I D D
rY w
A500H-29s1 O s D p€ a l 2-5 3/4%d-4 3/4
A •• VK 40UDATION
• ' ' � WALL NER'SEED
I
-------------------
3. 3.
i
r ' _
ap°s
m >� N 3 o €m z x
max m;e N A �
------------------
b-10 b'-10• ., VA 1/4' 6'-1 V2' 5'4 V4•
`V 3`'�O �•Du x r-O Np D r Os 11
• F � m
IA mo
(•^ oN O _ a v o um �� Lei _a�g� m
v rn
4-' S5A6 94 m s �S u A
T
cy/AV, F 3ag
D I l r
I 1
•y C F 0�� 0 J m�
0
155UED FOR CONSTRUCTION -
MARCH 02,2005
Arcnl-tech n,oclates.lm..nere
q g v & ADDITIONS $ ALTERATIONS TO THE eFlM1e5elydON;LSf�;wrlh
° O'DONNELL RESIDENCE r °hl °°a AiZCH I—TECH ASSOCIATES
L pyr ght R'otec[lon Act"of
r99p, Arty copy ILeralioo,
p oWc 11 or 61 IrIllIon f
° 172 OCEAN V I E IN AVE sex plans ultnOvt tnc a%p es6
urll[en consent of Archl-Tech 2 re I—i i tect u r2 I d e z i g n Inc.
1 € A m GOTUI T, MA55AGHUSETTS ��°"°t65'' 'I°an'"""IZ
O ant oomtnat act.Any
u e rots, I-1—0,
d15-
�' u panties on these draw- 6 school street tel-508-420-5335
(p O m hall tx broognt to the
O FOUNDATION/FIRST FLOOR PLANS t@ennjor Aran-term Assoof., - fax-500-420-5304
mc.prior to txq mg k. cotult,rrla 02635
DMenslons are to be sed.
do not s ala arawin s
3/10/2005 6:1 PM
i
o lul D
- O A
A -I
o D
o r
— O
r D
D 3
z _
to z
A> r 9,
o D
2 1 3/0'x 9 1/4'LVL 1mR. Zo Sl Z
2xl0 RAFTERS
` I 1
I I I
___ ___ _____ ___ _ _.
.___-__-_
i-Ib'OL. •
•u
a -
• 2xB5elb'OL.
2x10 RAFTERS
of•OL. ---- -- -- p
2x59 a Ib'O.G.
I
0 -_
y - .0 Tom9
�. _________ _____slb'OL. _� W 2xB5016'OL. 'e p
2x10 RAFTER5 I Is ___ ___ _
Plyot. --------- -------- Ir 2xB5016'OO.
1
I T
z
-yarn➢ ND
mod'- Nr N
A_ rn Ol a' rn
O rn Nz
N IT, 10
A z�rn OzN
O �XA rn0
t d N d M
m O -K
Z N -i
O O
:2 93
D rn
r -
155UED FOR CON5TRUCTION
MARCH 02,2005
Arch-Tech Az50clotes,Ins.herel -
g g q q a o a ADDITIONS 8 ALTERATIONS TO THE 1
[ne Arcn¢ect°`r`ai works
., O'DONNELL RE5IDENGE LopylghtP° tlon o' ARCHI—TECH ASSOCIATES
is Any copy,ater°uon,
172 OCEAN VIEW AVE poa llp or 1. twn or
m D O u.ese plan wthwt the a+press
O urltten core ne or Arcnl-Teen rc h itec"C u r2 I d e z i g n 1 Yl G.
o m GOTUIT, MASSAGHUSETTS me°11 th t "'r g°
e t F cnot (.Any
Lors.omisslons o als-
t' s s"`les on these aro.+- C school $trcmb rcf-508-420-5335
(N O inq n°Il be bro°gnt t°the
O FRAMING PLANS of a""°"of Arcnl-rN,n Ass°`, eobWt,ma 02635 fax- 508-420-5304
Inc.prior to be Ing cork.
Dimensions are E be sea,
do not scale drawin s
3/1/2005 2:50 Phl
1
�y �N
I
N
o A I
a
m
,____MIN.____
„ rn I
o r --
rn
----
` I
< I I �
D _
�Ao Fit gm a i N
I o
� k z
K rn > g`
m IR T9 I I
I V4'
r
D I I
� To ste acoa I
�—T-B In.
� 'oslert°°n �� I •�y
I
i I
I
I
I
I
I
I
MIN. O�n On �N2
NO g L
p
NIN
WAR
> � � y cj Egg z_
° u 3
- --
I
rn imp
N fly I •---
> rn
o _ a rn _
O
• .. FF F o� £>r a of 8 A -
„ A
o Z yxd�f y
N
rn I D I -- -----
_ I
wit
n
p
rr
i
_ MIN.
FN "� 1rn
N oo�P� I
pFAN
A
-------------
I
I
I
. I
I
155UED FOR GON5TRUGTION -
MARGH 01,2005
Archl-Tech As Io tes,Irc.hereW
g a a a g o ADDITIONS B ALTERATIONS TO THE a ee,ly re�e es they
a z,lghtovin ARCHI—TECH ASSOCIATES
° O'DONNELL RESIDENCE the Wo ks
Lapyr lght Protection Pct'of
(y f996. Arty copy Iteration,
prodxllon a glstrlWtian of
$ N g 2 172 OCEAN V I El^l AVE tneese plrns wlthWt the exp ess o--
O F N url[len consent of Archl-Tech rc h i-Vee-t U r�1 d Pi G i g n s i n c_
m GOTU I T, MASSACHUSETTS A550 lOtE9 ,lb in rl ge-
1 ^� - e rare om-1-or d�y
ponces on these dr°h- 6 eehool street tel-508-420-5335
W g - inq Hall tx txooght co me
N EXTERIOR ELEVATION /SECTION entlon of Archl-Tech Assoc.
inc.prior to be mmHg work. eotult,ma 02655 fax-500-420-5304
domens0,ore.61 or sea..